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| Friday, 18 October 2002 |
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Food advertising : A healthy probe Dr. Ananda Jayasinghe, senior lecturer in community medicine, Peradeniya Medical Faculty strongly feels that there should be an Ethical Council to approve advertisements on food items before they are carried in the electronic and the print media, as some of those advertisements that are now being carried are not food healthy and could lead to health problems in the community. In this article, Dr. Jayasinghe says "By no means I am trying to find fault with or blame the media or advertising companies for these advertisements because they must be doing their job to promote the products the way they think is best". However it is the duty of the health authorities to set up the machinery to ensure that those advertisements do not carry the wrong message to the people and that the advertisements conform to certain ethical and healthy guidelines.
These advertisements are the most attractive and appealing, appearing in all forms of media especially the television which is an extremely powerful medium. The tragedy of the story is that the children and young adults are being used for these commercials. As a result without their knowledge they contribute towards the nation in cultivating an unfriendly and unhealthy food habits. Without a shadow of doubt there is overwhelming evidence to suggest that the sausages and other fast food products have very detrimental effects on human health when taken regularly. Cholesterol and early childhood It is now well known that the process of cholesterol/fat deposition begins in very early childhood. With all this hard evidence is it morally justifiable or is it morally right to keep quiet and allow our children to be subjected to high-risk health situations? These bad food habits acquired in childhood will be very hard perhaps impossible to get rid of in adult life. Joint responsibility Therefore as health and media professionals of this country we jointly hold a moral responsibility to expose the dangers of such food items to the general public more specifically to the parents. Cigarette smoking Having understood all detrimental effects of cigarette smoking we were finally enlightened to prohibit the advertisements of cigarette. It took many a decade to take this measure. We also have prohibited advertisements on infant milk in order to promote breast-feeding. They are great victories achieved by the mankind in the modern era. The people who pioneered such efforts should be saluted. Ethical council As such I see no reason why we cannot adopt a similar policy. Therefore I strongly recommend a powerful Ethical Council to be appointed. i.e. For any food advertisement a prior approval or ethical clearance should be obtained from this ethical council.The members of the ethical council should be impartial and non-political. Their Impartiality could be ensured by being answerable only to the supreme court. Such a council should consist of experts in respective specialties. Time will unmask the truth However, if nothing is done within a reasonable period of time, whether we like it or not we are bound to witness more and more young people perishing due to heart attacks. If this opinion is not duly recognized, all what I have to say is that the time will unmask the truth. This is particularly the case, as by nature Asians are more vulnerable to ischaemic heart disease, diabetes etc. than the Europeans. Hence what is consumed in the west is most certainly not the best food for us. There is huge industry depending on sales of these food items. But surely the financial matters and interests should always be secondary to health. I wish to conclude by quoting the precious words of Lord Buddha "Arogya Parama Labha". A note on Dr. Jayasinghe Received Presidential Awards for figuring in the science citation Index of 2000. Consultant Paediatrician to the following childrens' orphanages in Central Province. a) Tikiri Niwasa Dangolla, b) Jayagrahanaya Children's Home Pilimathalawa, c) Lamarakshaka Children's Home Kandy, d) World Vision Friends Children's Protective Center. Introduction of new discipline of Community Paediatrics to the Undergraduate curriculum of the Faculty of Medicine in 1996. Introduction of the topic of child abuse to the undergraduate curriculum in 1996 and widely discussed and Lectured. Chairman of the International Conference on the "Humane Stray Dog Control for Effective Eradication of Rabies in Sri Lanka, held on the 7th and 8th of September 2002 at PGRC, Gannoruwa, Kandy. Prospective Chairman of the 6th International Medical Congress organized by the Peredeniya Medical School Alumni Association (PeMSAA) and Faculty of Medicine, Peredeniya, to be held in December 2002 in Kandy. Founder President KACPAW (Kandy Association of Community Protection through Animal Welfare) since 1999 todate. During my Presidency the KACPAW was granted association status with the RSPCA, UK (Royal Society for the Prevention of Cruelty to Animals) and associate member status with the WSPA, UK (World Society for Protection of Animals). *************************** Inappropriate medical education by Dr. Dennis J. Aloysius For centuries doctors have had an inappropriate medical education. Their undergraduate medical education does not properly prepare them for their life's work. Let us now examine a few general issues related to medical education. Medicine is a healing profession. Healing begins with caring. Medical education should prepare and train the future doctor to play a caring role, sincerely and competently. A criticism has been made that medical education seems to erode the students' personal sensitivity to a patient and that this unfortunately tends to bring into the profession, a large number of uncaring technocrats. The most important contribution that a doctor can offer to those who seek his care is kindness and sharing with them and their loved ones concern for what ails them. Does medical education, as it is currently structured result in the production of a compassionate doctor? There are several that think that it does not. There have been some recent changes in the curricula but these while being a step in the right direction are inadequate. Let us briefly review the process of medical education. Most adolescents plan a career in medicine from the age of fourteen or even earlier. For them, from then onwards, their time for relaxation, reflection reading, hobbies, sports, enjoying the arts, learning from the world around them, meeting and interacting with people from all walks of life, would be severely curtailed. Should we not have an entry examination that does not require a ridiculously disproportionate quantum of time spent in acquisition of factual knowledge. Should not extra-curricular activity also earn points in the marking system for admission? Should there not be an interview to evaluate suitability for entry into medical school? After entry the medical student undergoes 5 years of gruelling, intensive, exhausting and mind numbing training. This is sometimes followed by a long and strenuous period of postgraduate training. If the medical graduate desires to practise medicine of quality there must follow a lifetime of continuing medical education. Such a person would surely tend to have very little interest outside the field of medicine. They will surely ask themselves as Eliot did. "Where is the life we have lost in living? Where is the wisdom we have lost in knowledge? Where is the knowledge we have lost in information?" The Faculties of Medicine should strive to produce doctors who will hold dear to their hearts what is said in David Burkitts epitaph. "Attitudes are more important than abilities. Motives are more important than methods. Character is more important than power. And, the heart takes precedence over the head" *************************** Health Watch Question Box Replies to questions in this column are by Dr. D. P. Atukorale, Consulta Cardiologist and Health Watch Advisory Panel Member Albumin in urine Q. P. B. Abeywardena, from Badulla wants to know whether taking Tolbutamide 500 mg. captopril 25 mg. for hypertension and diabetic conditions for a person who also has albumin in urine would affect kidneys. Reply: Your albuminuria (passing albumin with urine) is due to your diabetes mellitus and hypertension which are causing nephropathy (involvement of kidneys) and your general physician has prescribed the best drugs for your diabetes and hypertension. Ace-inhibitors such as lisinopril and captropril are known to improve diabetic nephropathy and these drugs are very commonly used to control hypertension. If your kidney tests such as blood urea and serum creatinine are satisfactory, and if your abdominal U/S scan which is commonly performed in patients with nephropathy is O.K. you don't have to worry. Please carry on the instructions of your physician and see him regularly with renal function tests, which he or she will order from time to time. On chelation therapy Q. N. Mylvaganam from Peradeniya wants Dr. Atukorale's opinion whether his (writers) wife who is suffering from neuralgia who is now under treatment by a neuro physician would be benefitted if she goes into chelation therapy. Reply: My knowledge about chelation therapy is limited to the standard textbooks on the subject, scientific journals and information I got via the internet. As far as I am aware there is no evidence to show that chelation therapy (C.T.) helps patients suffering from trigeminal neuralgia. Trigeminal neuralgia is characterised by paroxysms of intense pain strictly confined to the distribution of the trigeminal nerve and in majority of patients the cause is not known. Your neurophysician has given you the best drugs and I am sure he/she has done all the essential investigations. With his/her treatment the patient has improved. Therefore it is advisable for your wife to follow the present treatment.For very ill patients who are resistant to medical treatment or when the patient gets severe hypersensitive reactions, your neuro physician might consider thermo-coagulation of the ganglion as a last resort. As your wife is improving, it is advisable for her to attend the neuro physician's clinic regularly. Health warning on peanuts Meliza Hassen from Mt. Lavinia writes Q: On Health Watch, Question Box of 6/9, you answered a question stating that all nuts including cashewnuts are good for health and gave plus points of the benefits derived by eating cashewnuts. I am surprised at the observations, for a few weeks back in an article courtesy "Guide to Vegetarian Living" - Health Warning on Peanuts", you copied this article and acknowledge that peanuts are capable of causing acute liver damage, liver cirrhosis & liver cancer, which compelled my grandfather to stop eating rata kaju nuts which he loved very much. My grandpa also eats several dates with all three meals. is it OK? Reply: Peanuts are one of the most nutritious nuts and contain very high levels of heart healthy mono-unsaturated fats and poly-unsaturated fats, very high concentrations of protein, significant amounts of vitamins A, nicotinic acid, riboflavin, pantothenic acid, vitamin B6, folic acid, calcium, iron and zinc. Spoilt peanuts contain aflatoxins which are poisonous alkaloids produced by fungus aspergillus flavus. When these spoilt peanuts are consumed one can get acute liver damage, liver cirrhosis and liver cancer. Fortunately above liver diseases following consumption of spoilt peanuts have not been reported in Sri Lanka as far as I am aware. If you consume peanuts available in our supermarkets, Jathika Pola or other reliable places (not those sold in Galle Face Green) you don't have to worry. Your grandfather can go on eating peanuts without any fear as liver complications following consumption of peanuts is extremely rare. As for consumption of dates, your grandfather should be allowed to continue his habit of eating dates with all three meals if he is not obese (over weight) and if he has no diabetes. ***************************
Kind hearted and patient friendly surgeon A former colleague in the Daily News Nimal Julige who is now in Kurunegala in a letter to the Health Watch wants to publicly commend the very kind hearted and patient friendly way a particular surgeon in the Oasis Hospital in Colombo treats his patients. He says he has observed this on several occasions he had visited this hospital to see a patient and he adds "when this kind of thing is given publicity even indirectly it makes other doctors also sometimes to change their unfriendly attitudes towards patients. Alzheimer's disease ten warning signs Consultant neurologist and Health Watch Medical Advisory Panel member Dr. Githanjan Mendis has picked the following article on - warning signs of Alzheimer's disease by the Alzheimer's Association USA, carried in the US medical publication for doctors - FP Report July 2001 for publication in the Health Watch.He says these signs are useful for the general public also to know, because it will help them to observe the onset of the disease in their elders early, get treatment and avoid complications and facing stressful situations later. Here's the item. New guidelines offer tips on Alzheimer's disease diagnosis, management Physicians can accurately diagnose 95 percent of patients with Alzheimer's disease and need to do so early. That's a key message from the American Academy of Neurology, which issued updated evidence-based clinical guidelines this spring on the detection, diagnosis and treatment of dementia in the elderly, with an emphasis on Alzheimer's disease. "We're talking about a disease for which there is no cure at the present time", says FP Tom Norris, M.D, associate dean of the University of Washington School of Medicine in Seattle. "It's not a situation where catching it early allows one to get started with definitive therapy that's going to slow the progress of the disease or cure the disease. The huge advantage - if we can catch this disease early - is that so much of it is an educational process, helping the family understand what's going on and what they can do". Physicians can also begin offering medications, behavioral suggestions and other support to help "avoid some of the problems that occur when the disease gets to fairly advanced stages without being recognised", says Norris, who has worked extensively with patients with the disease. For example, cholinesterase inhibitors have been shown to alleviate symptoms in some patients with mild to moderate Alzheimer's disease. The AAN Guidelines reflect the efforts of 21 experts who examined more than 6,000 abstracts. Although they don't include any major revelations, Norris says, they do feature useful information detailing the level of support for each recommendation. Alzheimer's disease is fairly common in the elderly. According to the AAN, 10 percent of people older than 65 and percent of those older than 85 suffer from the disease. Physicians, should identify and monitor mild cognitive impairment (memory impairment without dementia) because from 6 percent to 25 percent of patients with MCI progress to dementia or Alzheimer's disease, the AAN says. Norris encourages FPs to check-out the new guidelines, which were published in the May 8 issue of Neurology. To access them on line, go to http://www.aan.com and click on "Dementia Resources". He also encourages physicians to distribute a list of 10 warning signs (see below) to patients of families asking about Alzheimer's disease. Ten warning signs of Alzheimer's disease - * Memory loss that affect job skills Source: Alzheimer's Association *************************** New frontiers in intervention cardiology Another milestone was achieved on 15th October 2002 in Sri Lanka. Dr. Mohan Rajakaruna Dr. W.S. Santharaj on 15th October 2002 at the Durdans Heart Surgical Centre did an intervention on a patient having single vessel coronary artery disease. It is for the first time that Drug Eluting Stent was put in, in a patient. The CYPHER stent is a Rapamycin Coated stent which prevents neo intimal hyperplasia. The restenosis rate by using this type of stent is very low and patients tend to do much better on a long term basis. The restonosis rate in trials, in the West has been under 5%. This is the first time that this kind of stent has been used in Sri Lanka and another modality which is prognostically better has been added to the armamentarium for the near future. In the near future the cost of this stent will come down and become available for more and more patients in Sri Lanka. *************************** 40th World Congress of Integrated Medicine topics at discussion The 40th World Congress of Integrated Medicine to be held at the BMICH, Colombo on November 27th is scheduled to discuss the following topics among others. Nobel Prize Nominations in Medicine. * Nobel prize nominations in Medicine to be open for all practitioners of healing: The eligibility for nominations for Nobel Prizes has been denied to all complementary practitioners, whereas Alfred Nobel was a very sick man throughout most of his adult life and he was sustained with alternative medicines. A hundred years ago scientific allopathic medicine did NOT exist. It was Nobel's express intention to award a prize for the Medicine, which existed in his day, namely for Alternative Medicines. This is clearly written in his book last will, which is preserved in a glass box at The Nobel Foundation in Stockholm. Today, the medicine prize is being made impotent (and awarded) for such mundane non-happenings, such as the lack of an erection (viz. Viagra). The only clinician who was awarded a Nobel Prize was to surgeon Egas Moniz of Portugal, who created the pre-frontal lobectomy surgical operation for mental disorders. The results were devastating. It was the biggest ever, destructive disaster in surgical history. People were converted to virtual vegetables. One of his patients shot and killed the surgeon's assistant after being subjected to this horrendous surgery. * Euthanasia: Discussion on euthanasia with regard to its religious underpinnings and its societal, political and ethical impact. * Medical Councils: Airline pilots, ship captains, engineers, professors, researchers, teachers, computer programmers and operators, architects, bank managers, business executives, administrators and such like who are qualified in any one country can usually practise in any other country in the world. The human body is a standard species the world over and anyone qualified in an approved medical school in any country should be entitled to practise anywhere else in the world, as the basic human model in health and disease is the same. Therefore, the local medical councils should be abolished and one universal council for Integrated Medicine certification should be established under the aegis of the W.H.O. and United Nations. Certain medical councils are unionized corrupt bodies with their members conscripted through the backdoors by ballot rigging and they do not serve the best interests of neither the country nor its sick people. * Environment: The importance of environmental disharmony has been totally missed by the medical profession. To create a consciousness of the importance of man living in harmony with the environment should be a priority of a holistic health practitioner. "Prevention is better than cure" The results of these deliberations will be tabled and will be signed by the delegates from 140 countries and sent to the United Nations, W.H.O. and Nobel Prize Foundation in Sweden and to the respective government Ministers of Health, for their consideration and implementation. * Mother Lanka The Congress will also award an Honorary title 'Mother Lanka' to O. T. Engonona, who at 114 years of age has been acknowledged as the oldest living centenarian in the country by the Prof. Colvin Gooneratne Centenarian Study Committee, and already respected and honoured her for that position by the Organisation of Professionals Association of Sri Lanka by inviting her as a special guest of honour for the inauguration of their annual sessions held in Colombo on September 17th. Professor Gooneratne will present her at the Congress Sessions and briefly outline the details and objectives of the study done so far in association with the Health Watch. |
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He further adds that the advertising agencies should think whether it
is advisable, and proper to use babies and children to promote products,
who are mostly ignorant of, for what they are being used. The Health Watch
medical advisory panel feels that the whole article merits consideration
by those connected with the food advertising industry. Hence we are
carrying it in food faith in the interest of all concerned.
